Individual provider Active NPI

Ricardo Rodriguez Sr., DMD

  • Dentist
  • Aibonito, PR
National Provider Identifier
1356309686
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1885 Issued in PR
Practice address
Edificio Guayacan Calle Jose C Vasquez #202
Suite 111
Aibonito, PR 00705
Phone
(787) 735-4172
Fax
(787) 735-9234
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1885 PR Primary

Addresses

Primary practice location

Edificio Guayacan Calle Jose C Vasquez #202
Suite 111
Aibonito, PR 00705

Mailing address

Box 675
Aibonito, PR 00705
Phone (787) 735-4172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150821014744 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4082929823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1885PRMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1356309686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 675",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-735-4172",
            "fax_number": "787-735-9234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDIFICIO GUAYACAN CALLE JOSE C VASQUEZ #202",
            "address_2": "SUITE 111",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-735-4172",
            "fax_number": "787-735-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RICARDO",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "1885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aibonito, PR

Sources for this page

Verify at the official NPI Registry.